My treatment for rheumatoid arthritis, RA, is moving in the opposite direction of normal. Because I was diagnosed with two cancers and rheumatoid arthritis in the same year, the wonder drug biologics were off limits for me. They presented a higher cancer risk.
Eventually as my RA worsened, quality of life became a factor.
- Methotrexate(MTX) injections help, but not enough.
- I had tried the triple treatment of MTX, Plaquenil and sulfasalazine without success.
- Leflunomide was next, but it didn’t work either.
The small molecule DMARDs were exhausted as treatments. The biologics were next.
- Rituxan was considered the safest both by my rheumatologist and by my oncologist. I was infused with Rituxan. It didn’t work.
- Next safest was Orencia. I was infused with Orencia. It helped. It helped about 50% which was the norm for it. I received monthly infusions. But my flares became much worse at 10-11 months. Orencia was stopped.
Next is Remicade. Remicade, infliximab, was approved for RA in 1999. It is a TNF inhibitor. My rheumatologist had a serious discussion with me about cancer risk versus quality of life. I feel that the inflammation the RA causes in my body raises my cancer risk as well. I start the Remicade infusions on Tuesday.
The infusions are two hours. With labs, prep work and observation, I will be in the infusion center for 3+ hours. Remicade has a loading dose of three infusions. The second infusion is two weeks after the first and the third infusion is a month after the second. After the loading doses, the infusions will be eight weeks apart for me. Remicade offers flexibility in the dosage and the frequency of the infusions. It is a successful drug.
It is a chimeric. It includes a mouse protein. It makes me shudder to think a mouse part will be in my body. There is the risk of allergic reaction. It does happen. That is the reason for the precautions.
There is the risk of serious infections. 21% on Remicade develop a serious infection. Most biologics have this risk. I had a severe flu while on the Orencia. I will report back on the side effects that happen to me.
Remicade is more successful when given with methotrexate (I am on it).
My experience with the biologics is limited. For me Orencia worked 50%. And that was what the research said it might do. 50% of the patients will have a 50% improvement. I was confused initially and expected it to do more. However, when I think just how bad I was before Orencia, 50% looks pretty good.
I am optimistic about the Remicade. I expect that it will help me. My only foreseeable glitch will be my mammogram in September. If I have more breast cancer, I will be taken off the Remicade and my body will not be happy.